MHMR Tarrant’s proposed Nicotine Recovery Program (NRP) will address four primary needs: 1) high tobacco use and related cancer risks for individuals with behavioral health disorders, 2) the high tobacco use and related cancer risks for individuals with co-occurring behavioral health disorders and homelessness or chronic physical illness, 3) the high tobacco use of behavioral health treatment providers and 4) education of youth regarding the consequences of tobacco use.

The target population—individuals with major depression, bipolar disorder, schizophrenia, schizoaffective disorder, or substance abuse disorders—have significant barriers to quitting tobacco and are at high-risk of deve...

Read More

MHMR Tarrant’s proposed Nicotine Recovery Program (NRP) will address four primary needs: 1) high tobacco use and related cancer risks for individuals with behavioral health disorders, 2) the high tobacco use and related cancer risks for individuals with co-occurring behavioral health disorders and homelessness or chronic physical illness, 3) the high tobacco use of behavioral health treatment providers and 4) education of youth regarding the consequences of tobacco use.

The target population—individuals with major depression, bipolar disorder, schizophrenia, schizoaffective disorder, or substance abuse disorders—have significant barriers to quitting tobacco and are at high-risk of developing cancer. Behavioral health treatment providers also have high tobacco use rates at twice the national average (35%) and need tobacco treatment that fits their varied shift schedules.

To address the identified needs, the proposed NRP will: (1) train MHMR Tarrant behavioral health staff in tobacco cessation education reaching 2100 in the three year grant period, (2) provide comprehensive tobacco treatment to individuals with behavioral health disorders including those who are also homeless, and (3) provide comprehensive tobacco treatment to behavioral health treatment staff. Additionally, (4) the Nicotine Recovery Program will provide education to youth 10-24 to reconsider their current tobacco use behaviors using targeted outreach reaching 2700 individuals over three years. MHMR’s NRP will provide clinical services to 2000 individuals over three years, including 1800 individuals with severe behavioral health disorders and co-morbidities.

The target populations for the Nicotine Recovery Program are “captive audiences” that require minimal outreach. They are already receiving services at MHMR, the Local Mental Health Authority who provides all state-sponsored behavioral health treatment. Across 16 clinics, over 1000 individuals will be systematically screened for tobacco and referred to the program if they report use. Additionally, MHMR staff became subject to a tobacco-free workplace policy in 2016. MHMR Tarrant and Challenge of Tarrant County will reach out to youth in Tarrant County’s education systems and those in Tarrant’s juvenile justice.

MHMR Tarrant will use the evidence-based the “Integrating Tobacco Use Intervention Into Chemical Dependence Services” curriculum, developed by the Tobacco Interventions Project of the Professional Development Program, Rockefeller College, the University of Albany, offering both Nicotine Replacement Therapy (NRT) and counseling, including group sessions and one individual sessions with each participant. At their first and last group session, each participant will be asked to complete a Fagerstrom Test of Nicotine Dependence (FTND) and the National Health and Nutrition Examination Survey (NHANES) Smoking and Tobacco use module to evaluate the program’s impact on participants’ tobacco dependence.

Goals: 1) To reduce the risk of cancer due to smoking among individuals diagnosed with behavioral health disorders that are currently receiving Behavioral Health (BH) services, including those identified as homeless by providing NRP (Nicotine Recovery Program) in the BH clinics; 2) To reduce the risk of cancer due to nicotine use in MHMR employees by providing integrated Nicotine Recovery Program to staff; 3) To reduce the risk of cancer due to tobacco use among behavioral health homelessness and transitional housing populations; 4) To reduce the risk of cancer in youth and young adults aged 10-24 by providing tobacco education and community outreach.

In its systematic screening, referral, and engagement of behavioral health clients, the Nicotine Recovery Program can serve as a guide for system changes in other behavioral health treatment agencies across Texas, enabling other high-risk populations to receive tobacco cessation services. Working in integrated care facilities, the Nicotine Recovery Program may serve as an important example of partnerships between behavioral health providers, medical care providers, homeless and other service providers for tobacco cessation.

MHMR Tarrant’s tobacco-free workplace policy and approach to supporting employees who use tobacco will offer a critical example of how public agencies can structure wellness promotion, cancer risk reduction, and employee support. By providing tobacco education to youth, the Nicotine Recovery Program will provide opportunity for change in tobacco use later in life. Given the extremely high tobacco use of the target populations, the significant barriers they face to tobacco cessation and the increased risk of cancer their significant tobacco use causes, eliminating tobacco use for these populations can significantly reduce cancer rates for very vulnerable populations in Texas.

Read Less